Pitch Counts, Injuries And Hero Culture

(Inside Science) -- Justin Verlander, the ace starting pitcher of the Detroit Tigers, threw 5 innings and 91 pitches in last Monday's opening day 4-2 win over the Minnesota Twins. It was a good day for Tigers fans, but at 35 degrees, not a picture-perfect day to play baseball.

The Detroit Free Press reported that Tigers manager Jim Leyland "took out Verlander because he was getting near 100 pitches and he didn't want to risk anything on a cold day."

Pitch counts in baseball aren't a perfect science. Researchers do not know if there is a magic number of pitches that can minimize the risk of injuries for everyone. If a magic number exists, no one knows what it is, even though there are indications that throwing too many pitches can harm pitchers, especially when they're young. That's why Little League baseball has strict limits for pitches and innings. But, as any look through the pages of a sports section will tell you, pitchers often fall injured. The shoulder and elbow injuries they suffer can end careers, and are connected to the violent rotations inherent in throwing a ball at high speed.

For a contrast to that careful approach, this story from Yahoo shows the delicate balance between a pitcher's extraordinary performance -- some might consider it heroic -- and a coach acting irresponsibly. In a recent baseball tournament in Japan, a 16-year-old pitcher named Tomohiro Anraku threw 46 innings in five games over the course of nine days, totaling over 700 pitches. For perspective, the largest number of innings any major leaguer threw in a month during 2012 was 48, according to the Yahoo story. Only very rarely would a major-league pitcher start even three games in any nine-day period, and then he would almost certainly throw fewer than 400 pitches in that span.

The tournament, which is very important in Japan, occurs twice a year. The science angle here involves researchers' current knowledge about how pitching affects the body. Not all pitches are equal, and not all pitchers are equal, but many sports-science researchers argue for a common-sense approach to avoid unnecessary injury risks.

The Yahoo story quotes Glenn Fleisig, of the American Sports Medicine Institute, at length. Here's one point he stresses:

"The way humans are built, whether you're a 16-year-old or an old guy like me, your body needs 48 to 72 hours to recover from muscle fatigue and damage," Fleisig said. "If you have a big pitching workout or run distance, if you're fatigued where you have lactic acid and your muscles are sore, you need time to recover. If you pitch fatigued and come back in a day or two, your damage on your elbow and shoulder will add up. It won't be new. It's just compounding."

I had the opportunity to interview Fleisig in 2009, while writing a story about Stephen Strasburg, today of the Washington Nationals. Strasburg famously suffered a severe elbow injury in his rookie season, despite no obvious overuse or abuse of his arm. The Nationals have treated him carefully ever since his injury, limiting Strasburg's innings pitched last year, even as they went into the playoffs.

One of the most interesting things Fleisig told me in that interview is that he doesn't want to discourage kids from doing physical activity. "It's a fine line about pitching too much and pitching too little. There [are] a lot of people who do too little physical activity," he said. "The guy with the long career, he played a lot, but he listened to his body. When he was tired, he stopped, and then he pitched another day."

It's not like Japan is somehow unique in exposing young athletes to the potential for injury. The Yahoo story quotes Jon Daniels, the general manager of the Texas Rangers, as saying, "Don't get me wrong. I'm not minimizing it," Daniels said. "[But] I'm sure they look at high-school football and some of the injuries we have and say, 'I can't believe they let their kids do that.'"

And in 2009, a college baseball playoff game between Texas and Boston College lasted 25 innings. Two relief pitchers, one from each team, neither of whom were accustomed to pitching more than a couple of innings in a game, went more than nine innings. Austin Wood, from Texas, threw 13 innings that day. He had shoulder surgery in 2011, and according to a story from the San Antonio News-Express, doesn't regret his extraordinary effort, even if it could be proven that it caused his injury.

That's really the issue with pitch counts, and even concussions in football. How much risk is worth it to win a game -- for the athletes, for now and for their futures? How much do the athletes deserve the chance to play through any pain, to finish what they started? And how much responsibility do coaches have to protect their players, even if that means reducing their chance to win?

Those questions aren't easy to answer, and lots of people feel strongly on all sides of the issue.